| Predictions from the HPA indicate that the future burden of this disease on the health service will be substantial if preventative, diagnostic and treatment services are not escalated. This can already be seen in national mortality figures, hospital admissions and transplant data, which all show that hepatitis C related liver disease is continuing to increase year-on-year. In the North West the HPA model indicates that in six years time the estimated burden of associated illness will be high, with 1086 individuals likely to have cirrhosis and 1919 individuals dead as a result of hepatitis C infection. Erika continues: “As it is likely that this is an underestimate of the future disease burden, the need to continue strengthening specialist hepatitis C treatment services as well as general hepatology services is considerable. “In the North West, we have given the highest priority to testing individuals and bringing them into treatment for hepatitis C, however more needs to be done to increase awareness and improve access to services.” Currently, the greatest risk of contracting hepatitis in the UK is through sharing equipment for injecting drugs. Sharing injecting equipment, even on a one-off basis, or a long time ago (as many people remain asymptomatic for years), could place an individual at risk of hepatitis C. In the North West injecting drug users are the key risk group and the prevalence of hepatitis C among this group in the region is the highest in the country. Organisations across the North West are working together to improve prevention services for this key risk group. Hepatitis C is a viral infection which causes swelling or inflammation of the liver. It is transmitted when the blood of an infected person mixes with a recipient’s blood, such as via injecting drug use and the sharing of needles. Because hepatitis C infection is predominantly asymptomatic in the early years, many individuals remain undiagnosed until the disease has progressed. Some infections can remain undiagnosed until end-stage liver disease is reached, when a transplant becomes the only real option. | 
